Pakistan: Overcoming barriers to health care

A house destroyed by flooding that hit Gilgit-Baltistan in 2010, destroying infrastructure and leaving many communities isolated for months. Photo: Shifa Foundation

In northern Pakistan, an OCHA-supported project uses technology to bring doctors to patients cut off by floods.

The Gilgit-Baltistan region in Pakistan’s far north is known for its beauty, its mountains and its isolation. It is home to five of the 14 mountains in the world that reach higher than 8,000 metres. Its first road link to the rest of the country was only established in 1978, and access can still be cut by snowfall, avalanches or floods.

In 2010, floods crippled much of Gilgit-Baltistan’s fragile transport infrastructure. Thousands of people who needed to access health facilities were cut off.

Telemedicine is an approach that enables doctors and specialists to interact in real-time with patients living in remote areas. Using a satellite or internet link, a doctor or specialist is able to sit in front of a computer in Islamabad and interact with a patient thousands of kilometers away who is sitting in front of a telemedicine unit.

The telemedicine unit looks like a normal desktop computer with a webcam. But it comes with a range of diagnostic tools, including a stethoscope, cameras to monitor eyes, ears, throats and skin, and even ultrasound equipment. This means that consultations can go beyond simple discussions, and allow doctors and specialists to carry out physical examinations in a manner similar to traditional face-to-face visits.

Targeting isolated communities

The Shifa Foundation installed telemedicine units in hospitals in the cities of Khaplu, Astore and at a mother and child health centre in Pakora, Astore. These facilities were chosen because they all lacked the equipment and staff needed to provide primary health services. Each unit came with a consultant who was trained to use the different diagnostic tools. Patients were then connected with doctors and specialists based in Islamabad.

For Arbab Hussain, the telemedicine unit meant that his son Tanveer could continue to receive treatment. Eighteen-month-old Tanveer has faced health issues since he was born.

“My wife and I had struggled to cope with this situation. (But) since Dr Yawar (a consultant pediatrician with Shifa International) has been helping us through telemedicine, we feel like we have turned a corner and Tanveer is starting to show signs of improvement. Watching him sleep peacefully at night, there is no greater joy for us.”

An ongoing solution?

The telemedicine project was initially planned for six months to help communities who were still recovering from the floods. However, the Shifa Foundation, in coordination with government authorities and other local groups, has been able to continue running the telemedicine facilities, providing much needed medical outreach for dozens of patients.

“Based on my experiences, I think there is a growing need for telemedicine in Pakistan,” said Dr Abdus Salam, Shifa International’s Director of Emergency Response. “In regions where there are problems in accessibility for doctors, this technology plays a bridging role and can allow even the most remote and marginalized population access to quality healthcare.”

In all, more than 1,500 patients have benefited from the telemedicine services so far.

Innovation and aid

This project is a good example of how new communication and information technologies can improve humanitarian response, says Laksmita Noviera, OCHA’s manager of the Pakistan Emergency Response Fund.

“This shows how technology can help us overcome geographical barriers and minimize costs. In the past, a lot of these people would have probably missed out on medical support. But now, literally with the click of a button, they can reach out to their doctor,” says Ms Noviera.

This project was recently recognized for its innovation amongst hundreds of ERF allocations. For more on how technology is improving and reshaping humanitarian assistance, visit www.unocha.org/hina or read the recent OCHA report Humanitarianism in the Network Age. The Asia Pacific launch of this report is taking place this Thursday (30 May) in Bangkok, Thailand. More information on the launch is available here.